Cardiac manifestations of complex partial seizures

Devinsky, Orrin; Price, Bruce H.; Cohen, Stafford I.

doi:10.1016/0002-9343(86)90009-4

Cited by 67 publications

(34 citation statements)

References 29 publications

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“…Ten of the 13 patients identified in this series had a diagnosis of epilepsy without a suspicion of a bradyarrhythmia, and the diagnosis would have been missed without simultaneous video-EEG/ECG monitoring. In two of our cases and in six ictal bradycardia patients in the literature, ictal bradycardia was diagnosed only after cardiac pacing failed to control symptoms in patients previously diagnosed with cardiogenic or vasovagal syncope based on ECG monitoring alone [4,6,7,11,16]. Prolonged ECG monitoring without EEG may mislead the physician, as the finding of bradycardia coincident with a logged clinical event during prolonged ECG monitoring may suggest a primary cardiogenic diagnosis [14].…”

Section: Discussionmentioning

confidence: 72%

Clinical cues for detecting ictal asystole

et al. 2007

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Section: Discussionmentioning

confidence: 72%

Clinical cues for detecting ictal asystole

et al. 2007

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“…One series comprised five patients with seizures who presented with recurrent and mostly atypical chest pain and a negative ischemia work-up who responded to antiepileptic treatment (Devinsky et al, 1986). However, these results have not been validated with video EEG monitoring, and it remains speculative if the chest was truly provoked by epileptic seizures.…”

Section: Acute Effects Of Seizures On the Heartmentioning

confidence: 99%

Effects of Seizures on Cardiac Function

Schuele

2009

Journal of Clinical Neurophysiology

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Various chronic and acute autonomic effects on the heart are seen during epileptic seizures, and some have been implicated in cases of sudden unexpected death in epilepsy (SUDEP). Chronic autonomic dysfunction, either congenital or acquired through seizures or medications, and structural changes of the heart may all predispose patients to SUDEP. Acute autonomic changes during seizures, in particular ictal bradycardia or transient ischemia, may indicate an increased and preventable risk of mortality in patients with epilepsy. However, there is no definite epidemiologic evidence associating any of the chronic or acute cardiac effects of seizures with SUDEP. Cases of SUDEP and near-SUDEP recorded during long-term electroencephalography monitoring offer some insight into the potential mechanisms leading to SUDEP. These cases suggest that autonomic instability ending in cardiorespiratory arrest may be provoked by postictal suppression rather than by ictal activation of the autonomic nervous system. Additional epidemiologic studies on high-risk populations and access to recorded cases of SUDEP may provide more details about the exact sequence of events leading to death and thus guide the development of possible preventive strategies.

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“…■ Seizure-induced syncope A variety of electrocardiogram (ECG) abnormalities have been described in patients with epilepsy, including QT prolongation, R on T phenomenon, bundle branch block, ectopy, bradycardia, and asystole [7,18,27,43, also see Freeman this issue]. The most common cardiac arrhythmia associated with seizures is sinus tachycardia [4].…”

Section: Syncope or Seizures?mentioning

confidence: 99%

Seizures and syncope:

Britton

Benarroch

2006

Clin Auton Res

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Although pathophysiologically distinct, syncope and seizures share clinical characteristics which may make diagnosis difficult. Adding to diagnostic complexity are the facts that seizures and syncope may coexist in the same patient, syncope may be associated with seizure-like motor manifestations, and seizures may be complicated by cardiac arrhythmia and syncope. Combined EEG/ECG telemetry is sometimes necessary to establish the correct diagnosis. These techniques also provide an opportunity to study the role of certain cortical regions in the modulation of cardiac function. There is an increasing understanding of the central autonomic pathways involved in the genesis of the cardiovascular changes that occur during epileptic seizures. This article reviews the use of EEG/ECG telemetry in the evaluation of syncope and seizures, and the neuroanatomic circuitry involved in the production of the cardiovascular manifestations of seizures.

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Cardiac manifestations of complex partial seizures

Cited by 67 publications

References 29 publications

Clinical cues for detecting ictal asystole

Clinical cues for detecting ictal asystole

Effects of Seizures on Cardiac Function

Seizures and syncope:

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